Details

Autor(en) / Beteiligte

• Wong, Carrie R
• Trinh, Huy N
• Yip, Benjamin
• Nguyen, Huy A
• Garcia, Ruel T
• Ahmed, Aijaz
• Keeffe, Emmet B
• Nguyen, Mindie H

Titel

High Rate of Complete Viral Suppression With Combination Therapy in Patients With Chronic Hepatitis B and Prior Treatment Failure

Ist Teil von

• Journal of clinical gastroenterology, 2011-11, Vol.45 (10), p.900-905

Ort / Verlag

Hagerstown, MD: Lippincott Williams & Wilkins, Inc

Erscheinungsjahr

2011

Quelle

MEDLINE

Beschreibungen/Notizen

• BACKGROUNDCombination therapy for chronic hepatitis B virus (HBV) infection is recommended for patients with antiviral resistance (AVR) or partial response (PR) to earlier antiviral therapy; however, data on outcomes are limited. GOALSTo determine the rate of complete viral suppression (CVS) with combination therapy and to compare CVS among different indications and treatment regimens. METHODSA cohort of 109 consecutive patients with chronic hepatitis B from 3 liver clinics in Northern California was retrospectively studied. All patients started combination therapy between April 2004 and August 2009 for the following indicationsAVR (n=29), PR (n=60), or others (n=20). Combination treatments included lamivudine (LAM), adefovir (ADV), telbivudine (LdT), entecavir (ETV), tenofovir (TDF), and emtricitabine (FTC). CVS was defined as undetectable serum HBV DNA <100 IU/mL. RESULTSAmong the patients, who were nearly all Asian (99%), 73% had ≥2 prior treatments and 82% had treatment failure (AVR or PR). Median treatment duration of combination therapy was 21 months (range, 6 to 50 mo). The majority (77%) achieved CVS after 6 months of various combination regimens80% for ETV+TDF, 76% for TDF+LAM or FTC or LdT, 75% for ETV+ADV, and 69% for ADV+LAM or LdT (P=0.86). After 6 months of therapy, CVS was observed in a similar proportion of patients treated for PR and AVR (72% and 74%, respectively). CONCLUSIONSAlthough the majority of 109 treatment-experienced patients had prior treatment failure, high rates of CVS were rapidly achieved and did not significantly differ between indications of AVR and PR or between ETV-based and TDF-based regimens.